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Gender differences in the association between biomarkers of environmental smoke exposure and developmental disorders in children and adolescents

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Abstract

Effects of environmental tobacco smoke (ETS) exposure on children and adolescent health outcomes have been attracted more and more attention. In the present study, we seek to examine the gender-specific difference association of environmental smoke exposure biomarkers and developmental disorders in children and adolescents aged 6–15 years. US nationally representative sample collected from the National Health and Nutrition Examination Survey (NHANES) 2007–2014 was enrolled (N = 4428). Developmental disorders (DDs) are defined as a positive answer to the question, “Does your child receive special education or early intervention services?” Serum cotinine and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) were utilized as acute and chronic exposure biomarkers of ETS, respectively. Participants with serum cotinine >0.015 ng/mL were considered as with acute ETS exposure, and participants with creatinine-adjusted NNAL >0.0006 ng/mL were considered as with chronic ETS exposure. A survey logistic regression model was used to estimate the association between ETS exposure biomarkers and DDs. Additive interaction was utilized to examine the interaction of gender and biomarkers of ETS. Overall, approximately 9% of children were defined as DDs, and 65% of children had serum cotinine and urinary NNAL levels above the limit of detection. In the adjusted models, the association of ETS exposure biomarkers with DDs was only observed in girls. Girls with low cotinine levels and high urinary NNAL levels had 2.074 (95% CI: 1.012–4.247) and 1.851 (95% CI: 1.049–3.265) times higher odds of being DDs than those without ETS exposure, respectively. However, the effects of boys and NNAL exposure on DDs have additively interacted. Our findings first provided strong evidence for gender differences in the association between two tobacco metabolites and DDs in children, disclosing the public health implications and economic burdens of environmental tobacco smoke exposure.

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Data availability

The data presented in this study are available from https://www.cdc.gov/nchs/nhanes/.

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Funding

This study is supported by the National Natural Science Foundation of China (NSFC) (No. 81703209), the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD), and the Scientific research project of the Jiangsu Commission of Health (Y2018030).

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Author notes

  1. Zixuan Wang, Hui Shi and Ling Peng contributed equally to this work.

Authors and Affiliations

  1. Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, Jiangsu, China

    Zixuan Wang, Hui Shi & Ling Peng

  2. School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, PR China

    Yue Zhou

  3. Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, Jiangsu, China

    Ying Wang

  4. School of public health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, Jiangsu, China

    Fei Jiang

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  1. Zixuan Wang
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Contributions

Zixuan Wang: conceptualization, methodology, software, writing – original draft preparation. Hui Shi: conceptualization, data curation, writing – original draft preparation. Ling Peng: methodology, data curation, writing – review and editing. Yue Zhou: software. Ying Wang: writing – review and editing, funding acquisition. Fei Jiang: supervision, project administration, writing – review and editing, funding acquisition.

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Correspondence to Fei Jiang.

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The NHANES is approved by the NCHS Research Ethics Review Board, and all participants provided written informed consent.

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Not applicable. Available secondary data were used in this publication.

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The authors declare no competing interests.

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Responsible Editor: Lotfi Aleya

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Wang, Z., Shi, H., Peng, L. et al. Gender differences in the association between biomarkers of environmental smoke exposure and developmental disorders in children and adolescents. Environ Sci Pollut Res 29, 84629–84639 (2022). https://doi.org/10.1007/s11356-022-21767-w

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